¶ … client, whose name is Kate and is the main character in the 2013 film Smashed, displays compulsive behavior and a marked addiction towards alcohol and the classic symptoms of alcoholism in the scene in which she parks her car before going to teach elementary school. This scene takes place early one in the film, and indicates the sort of behavior that will characterize Kate's descent into alcoholism. Despite the fact that she is late for work because she is hung over, she still cannot refrain from consuming more alcohol -- in the form of whiskey, straight. This scene indicates that not only is Kate psychologically addicted to this substance, but it is also affecting her ability to engage in normal activities (such as work). Drinking hard liquor prior to beginning a work day in which one will be grooming the future of young children is extremely dysfunctional behavior. So is continuing to drink the morning after a night spent drinking and waking up hung over. This scene certainly indicates the fact that Kate has a problem with alcohol, and with addiction in general since she cannot keep from consuming the substance.
Diagnosis/Symptoms
Although the movie is not very realistic in how it portrays Kate's substance abuse disorder (it is highly unlikely that Kate could spend the night passed out with crack heads and still wake up with her car and its keys intact, for instance) the symptoms of this disorder are portrayed accurately. One of the symptoms of clinical addiction is that the client feels as though he cannot help but to commit the addictive behavior. Kate obviously feels guilty about her binge drinking; early on she tells Charlie that she thinks she needs help which indicates the fact that she wants to change her behavior. But as the pair resolve to "slow down" on the alcohol, and promptly resume drinking to intoxication, it becomes clear that Kate is not capable of breaking the cycle of addiction on her own. Thus, she has a strong craving to use a substance (alcohol) and continues to use the substance despite knowing its harmful effects.
Kate displayed withdrawal symptoms when she took a sip of a beer prior to taking a shower after she woke up hung over in the opening scene. Her substance abuse led to her dearth of fulfilling her role at work when she had to go home that same day because she was hung over. Her drunk driving when she smoked cocaine was indicative of her using alcohol in situations which could be physically dangerous. The scene in which Kate stole a bottle of wine, despite all of the resistance she got from the store owner, was demonstrative of the symptom in which client's spend great deals of time attempting to procure their substance of choice. One of the only symptoms that Kate did not display was giving up valued social pursuits because of her substance abuse, largely because her social life consisted of drinking.
Aetiology/Formulation
Smashed makes it perfectly clear that the origins of Kate's disorder is partly rooted in a biological framework. The film alludes to this fact by showing that Kate's mother is an alcoholic; she chooses to "celebrate" Kate's visit by drinking cocktails, and openly disparages Alcoholic Anonymous. Kate's mother also alludes to the fact that Kate's father left them because he was able to overcome his own alcoholism. These details mean that there is a genetic trait predisposing Kate to an alcohol-based substance abuse disorder. However, it is key to note that one of the protective factors that helps Kate to overcome this disorder is her penchant for honesty -- a trait which was honed by her disorder meetings. This protective facet helps her to overcome her biological predisposition for alcoholism, which is demonstrated by her honestly revealing to her mother that she stopped drinking.
The movie also makes it clear that there are social factors which are perpetuating Kate's disorder. These factors largely consist of the influence of her husband and his network of friends/family. All of these individuals drink heavily and recreationally, making it difficult for Kate to be around them and not do the same. Thus, Kate has little choice but again to rely on her own sense of honesty and tell her husband that she cannot remain sober around him -- and then leave him.
The psychological factors that contributed to Kate's disorder are alluded to in the film and require viewer inference. It appears as though Kate's environment played a profound role in her developing this disorder. Since both of her parents are alcoholics, she has probably always associated drinking with most aspects of life which psychologically maintained her proclivity to drink. She evinces her strength and reliance on honesty to eventually...
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